Diabetes Canada’s Policy Statement for Reimbursement of Intermittently-Scanned and Real-Time Continuous Glucose Monitoring Systems
This year marks the 100th anniversary of the revolutionary Canadian discovery of insulin. While there have been many important diabetes treatment advances and technology innovations in the past century, there is still no cure. Diabetes rates continue to rise significantly and funding decisions by governments and private payers related to health systems are being made in an environment of limited financial resources.
Under all circumstances, patients should be at the centre of health policy decisions. People living with diabetes must be supported to achieve their full health potential, with rightful consideration given to the cost of doing so. Greater access to devices that help enhance diabetes management and quality of life can reduce downstream health-care costs related to disease complications.
Diabetes Canada’s new Reimbursement of Intermittently-Scanned (isCGM) and Real-Time (rtCGM) Continuous Glucose Monitoring Systems Policy Statement suggests the creation of equitable policies for people with diabetes and provides evidence-informed recommendations for glucose monitoring devices.
“Glucose monitoring can play an important role in optimizing clinical outcomes, improving treatment satisfaction and enhancing quality of life for many people living with diabetes,” says Dr. Seema Nagpal, Vice-President of Science and Policy with Diabetes Canada. “isCGM and rtCGM can guide diabetes management strategies, inform treatment decisions and promote safety from a health emergency like diabetic ketoacidosis and hypoglycemia.”
isCGM (previously referred to as “flash glucose monitoring” or “FGM”) and rtCGM (previously referred to as “continuous glucose monitoring” or “CGM”) technology can be transformative for many people living with diabetes and therefore should be accessible to all Canadians for whom there is evidence of benefit. Diabetes Canada’s reimbursement recommendations prioritize safety and are based on clinical indications and individual circumstances. They are specific to diabetes type (i.e. type 1, type 2, gestational), treatment and certain considerations. The entire set of reimbursement recommendations can be found here.
“We appreciate the input and support of people living with diabetes, caregivers, health-care providers and policy experts in the development of this statement,” says Dr. Nagpal. “Diabetes Canada looks forward to discussions with public and private payers to ensure all people living with diabetes have access to device that suits their personal needs based on consultation with their health-care team.”
Currently, coverage of both isCGM and rtCGM varies across Canada. The Yukon was the first jurisdiction in Canada to publicly cover both isCGM and rtCGM for individuals living with type 1 diabetes and other provinces and territories are following suit.
Diabetes Canada will continue to advocate for reimbursement policies to be put in place where there are none and for expanded coverage to be offered where it is not sufficiently comprehensive, per these new recommendations. Current coverage information across the country can be found here.